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Prevalence Rates and Epidemiological Risk Factors for Astigmatism in Singapore School Children

TONG, LOUIS MBBS, FRCS; SAW, SEANG-MEI MBBS, PhD; CARKEET, ANDREW PhD; CHAN, WAI-YING BSc(Hons) Optom, GDComp Sci, FIACLE; WU, HUI-MIN MD, MSc; TAN, and DONALD MBBS, FRCS, FRCOphth, FAMS

Articles: Original Article

Purpose. This study examined the prevalence rate of astigmatism and its epidemiological risk factors in Singapore school children.

Methods. In a study of school children aged 7 to 9 years old in two schools in Singapore in 1999, a detailed questionnaire was administered to parents regarding reading or close-work habits, past history of close-work, family history, and socioeconomic factors. Cycloplegic refraction was performed five times in each eye. Defining astigmatism as worse than or equal to 0.5, 0.75, and 1 D cylinder in the right eye, the prevalence of astigmatism was calculated.

Results. The study population consisted of 1028 children. The prevalence rate of astigmatism (worse than or equal to 1 D cylinder) was 19.2% (95% confidence interval, 16.8 to 21.6). This was not different between genders, ethnic groups, or age (p > 0.05). With-the-rule astigmatism was more common than against-the-rule astigmatism. The prevalence of astigmatism and myopia was 9.8% (95% confidence interval, 8.0 to 11.6). A high AC/A ratio was associated (p = 0.003) with astigmatism, even after exclusion of myopic children. On vectorial analysis, J0 and J45 were associated with the number of hours of playing video games, whereas J45 was also associated with computer use. Only J45 was associated to male gender, a high AC/A ratio, and a family history of myopia.

Conclusions. The prevalence rate of astigmatism (≥1 D) was 19%. Playing video games and computer use may be associated with astigmatism severity, although the presence of astigmatism (≥1 D) was not associated with any nearwork factors. A family history of myopia was associated with oblique astigmatism severity. A high AC/A ratio is associated with astigmatism, and this requires further investigation.

Singapore National Eye Centre (LT, DT), Department of Community, Occupational and Family Medicine, National University of Singapore (SMS), Singapore Eye Research Institute, Singapore (AC, WYC, DT), Defence Medical Research Institute, Singapore (HMW), Department of Ophthalmology, National University of Singapore (DT)

Received January 19, 2002;

revision received May 9, 2002.

Louis Tong

Singapore National Eye Centre

11 Third Hospital Avenue

Singapore 168751

e-mail:Louistong@hotmail.com

© 2002 American Academy of Optometry